Associations between initial heart rhythms and self-reported health among cardiac arrest survivors - a nationwide registry study.

BACKGROUND: Non-shockable initial rhythm is a known risk factor for high mortality at cardiac arrest (CA). However, knowledge on its association with self-reported health in CA survivors is still incomplete. AIM: To examine the associations between initial rhythm and self-reported health in CA survivors. METHODS: This nationwide study used data from the Swedish Register for Cardiopulmonary Resuscitation 3-6 months post CA. Health status was measured using EQ-5D-5L and psychological distress by the Hospital Anxiety and Depression Scale (HADS). Kruskal-Wallis test was used to examine differences in self-reported health between groups of different initial rhythms. To control for potential confounders, age, sex, place of CA, aetiology, witnessed status, time to CPR, time to defibrillation, and neurological function were included as covariates in multiple regression analysis for continuous and categorical outcomes. RESULTS: The study included 1783 adult CA survivors. Overall, the CA survivors reported good health status and symptoms of anxiety or depression were uncommon (13.7% and 13.9% respectively). Survivors with PEA and asystole reported significantly more problems in all dimensions of health status (p=0.037 to p<0.001), anxiety (p=0.034), and depression (p=0.017) compared to VT/VF. Overall, these differences did not remain in the adjusted regression analyses. CONCLUSIONS: Initial rhythm is not associated with self-reported health when potential confounders are controlled. Initial rhythm seems to be an indicator of unfavourable factors causing the arrest, or factors related to characteristics and treatment. Therefore, initial rhythm may be used as a proxy for identifying patients at risk for poor outcomes such as worse health status and psychological distress.

Associations between comorbidity and health-related quality of life among in-hospital cardiac arrest survivors - A cross-sectional nationwide registry study.

AIM: The aim of this study was to explore associations between comorbidities and health-related quality of life (HRQoL) among in-hospital cardiac arrest (IHCA) survivors. METHODS: This registry study is based on data from the Swedish Registry of Cardiopulmonary Resuscitation (SRCR) collected during 2014-2017. HRQoL was assessed using the EQ-5D-5L, the EQ Visual Analogue Scale (EQ VAS) and the Hospital Anxiety and Depression Scale (HADS). In total, 1,278 IHCA survivors were included in the study, 3-6 months after the cardiac arrest (CA). Data were analysed with descriptive and inferential statistics. The comorbidities analysed in this study were the patients' status for diabetes, previous myocardial infarction, previous stroke, respiratory insufficiency, and heart failure. RESULTS: Overall, the IHCA survivors reported high levels of HRQoL, but there was great variation within the population, e.g., EQ VAS median (q1-q3) = 70 (50-80). Survivors with one or more comorbidities reported worse HRQoL in 6 out of 8 outcomes (p < 0.001). All studied comorbidities were each associated with worse HRQoL, but no comorbidity was associated with every outcome measure. Previous stroke and respiratory insufficiency were significantly associated with every outcome measure except for HADS Anxiety. The linear regression models explained 4-8% of the total variance in HRQoL (p < 0.001). CONCLUSION: Since IHCA survivors with comorbidities report worse HRQoL compared to those without comorbidities, it is important to pay directed attention to them when developing and providing post-CA care, especially in those with respiratory insufficiency and previous stroke.